Abstract | BACKGROUND: METHODS: MEDLINE and EMBASE were searched to identify relevant randomized controlled clinical trials published from January 1968 to November 2006. We identified additional studies by searching bibliographies of retrieved articles. RESULTS: Compared with placebo, systemic corticosteroids reduced treatment failure by 46% (95% confidence interval [CI], 0.41 to 0.71), length of hospital stay by 1.4 days (95% CI, 0.7 to 2.2), and improved FEV(1) by 0.13 L after 3 days of therapy (95% CI, 0.04 to 0.21). Meanwhile, the risk of hyperglycemia significantly increased (relative risk, 5.88; 95% CI, 2.40 to 14.41). Compared with placebo, antibiotics reduced treatment failure by 46% (95% CI, 0.32 to 0.92) and in-hospital mortality by 78% (95% CI, 0.08 to 0.62). Compared with standard therapy, NPPV reduced the risk of intubation by 65% (95% CI, 0.26 to 0.47), in-hospital mortality by 55% (95% CI, 0.30 to 0.66), and the length of hospitalization by 1.9 days (95% CI, 0.0 to 3.9). CONCLUSIONS: For acute COPD exacerbations, systemic corticosteroids are effective in reducing treatment failures, while antibiotics reduce mortality and treatment failures in those requiring hospitalization and NPPV reduces the risk of intubation and in-hospital mortality, especially in those who demonstrate respiratory acidosis.
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Authors | Bradley S Quon, Wen Qi Gan, Don D Sin |
Journal | Chest
(Chest)
Vol. 133
Issue 3
Pg. 756-66
(Mar 2008)
ISSN: 0012-3692 [Print] United States |
PMID | 18321904
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Anti-Bacterial Agents
- Glucocorticoids
|
Topics |
- Anti-Bacterial Agents
(therapeutic use)
- Controlled Clinical Trials as Topic
- Glucocorticoids
(therapeutic use)
- Humans
- Positive-Pressure Respiration
(methods)
- Pulmonary Disease, Chronic Obstructive
(therapy)
- Recurrence
- Treatment Outcome
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